Individual
MR. RANDALL LEE WRIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT,ATC
Contact information
Practice address
3000 CHRYSLER DR, BELVIDERE, IL 61008-6006
(815) 547-2440
(815) 547-2458
Mailing address
10009 SARA DR, ROSCOE, IL 61073-8598
(815) 623-9024
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Enumeration date
03/13/2007
Last updated
07/08/2007
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